BC Children’s Hospital is proud of its long tradition of providing quality internship training (now referred to as a residency). We are presently beginning (2011) our thirtieth year of a continuously operating psychology residency program. Many of our former residents have gone on to successful psychology careers in B.C., other Canadian provinces and the U.S., and most have maintained close ties with our Department. Beginning with the 1992 academic year, this internship was expanded to two interns and included the opportunity to work at Sunny Hill Health Centre for Children and the G.F. Strong Rehabilitation Centre. Beginning with the 2002 academic year, the internship expanded to three interns. Since 2008, our internship has included only two sites; BC Children’s and Sunny Hill. Our program is a broad based clinical psychology residency designed to build competence in pediatric and child clinical psychology, including medical psychology, mental health, and developmental disabilities. The primary focus of the training is on children and youth as well as their families.
There is a strong emphasis on specialized assessment skills across the developmental spectrum and on short-term therapeutic interventions. Some trainees may choose to emphasize specialized areas related to their academic backgrounds, but our program ensures that all trainees obtain a broad base of skills, so that they are prepared to practice with a broad range of ages and presenting problems, in a variety of settings.
Residents have access to an extremely varied menu of seminars and outside lectures. They are free to attend relevant seminars and rounds at BC Children’s plus those presented by Sunny Hill. In addition, the Psychology Departments at both the University of British Columbia and Simon Fraser University have colloquia and other invited addresses open to our residents.
We are a CPA accredited** clinical psychology residency and we abide by the rules and deadlines established by these professional organizations. We will be taking part in the APPIC computer match on selection day and consequently all student applicants must also be registered for the match (please see specific information on this in our information package). Potential applicants can also read about the application process on the APPIC website.
** We were previously a CPA and APA accredited residency. In February 2007, the Council of Representatives of the APA voted to cease accrediting doctoral and internship programmes in Canada. Concurrent CPA/APA accreditation for all programs will cease as of September 2015 and as of January 1, 2008, the APA no longer accepts new applications for accreditation of Canadian programmes. Given this situation, we did not apply for APA re-accreditation for the 2012-13 year. For further information please refer to the Accreditation sections of both the CPA and APA websites.
The residency seeks to develop a balance of both assessment and therapy skills across a broad range of patient populations. BC Children’s offers experiences both in specialized assessments and various forms of short term intervention and therapies (see our Department Programs List later in this document). Residents carry some longer term therapy cases and learn the skills required for short term inpatient therapeutic interventions.
In order to meet the goal of a broad-based residency with both assessment and therapy experience, the resident and the Director of Training will meet and review the specific strengths and weaknesses of the individual and devise an individual program that is mutually satisfactory to both the student and the program. Goal-setting and evaluation reflect a competency-based approach to training.
Students begin with a two week orientation at Children’s and continue with didactic activities and group supervision at BC Children’s on Mondays and Fridays throughout the year. This consistent Monday and Friday placement allows for peer support among the residents, and also makes it possible to carry one or two longer term therapy cases throughout the year. The month of August, at the end of the residency, is also spent together at BC Children’s working on the completion of all tasks.
Tuesdays, Wednesdays, and Thursdays are devoted to major and minor rotations. Major rotations occur within three training blocks: (1) Pediatric Psychology (based at BC Children’s), (2) Child and Youth Mental Health (based at BC Children’s), and Developmental Disabilities (based at Sunny Hill). At any given time, there is one resident working in each of these three areas; each resident cycles through all three blocks over the course of the year. Because there is only one trainee working in a given area of practice at one time, residents are not competing for rotation supervisors, and if two residents request experience in the same specific area in the same year, we are usually able to accommodate their wishes.
At the beginning of each block, the resident will meet with the Director of Training and the Site Supervisor to set mutually agreed upon goals and to design a plan that most closely meets the needs and interests of the student and the site. At the end of the block, the goals will be reviewed and adjustments made prior to the next rotation. The resident meets weekly with the Site Supervisor and participates in group supervision with the Director of Training. Group supervision is seen as an essential component of our residency, bringing continuity and coherence to the experience of working with different rotation supervisors throughout the year. This also allows us to fine tune and refine the goals and experiences of the resident as we go along. We can be flexible and adjust case loads or modify the training depending on the day-to-day experience of the resident.
In addition, the residents are expected to attend and present at weekly Case Consultations and bi-weekly Clinical Rounds at BC Children’s where specific cases and therapeutic issues are discussed. A requirement of the residency is that each resident will present at least once at Clinical Rounds at BC Children’s and once at Sunny Hill. Seminars on Ethical Issues, Therapy, Assessment, Supervision, and Diversity plus other topics of interest are arranged with staff psychologists and scheduled on a regular basis for the benefit of the residents. Please see the description of typical course offerings included in this package.
Vancouver is one of the most culturally diverse and ethnically mixed communities in North America. Consequently, the population the hospital serves is equally diverse. Thus, for example, the hospital has provided interpreters in over 35 different languages. This gives a sense of the opportunities residents have to practise psychology within a positive, multicultural milieu. We are equally committed to training and experience in the area of multicultural issues. While the sessions vary from year to year, past years’ residents have had the opportunity to attend sessions on: First Nations Health Care Issues, Understanding Your Chinese Patient: An Introduction to Cantonese Language and Culture, and American Sign Language. These courses are offered site-wide exclusively for health workers who wish it.
We are committed to the idea that this is a training year for the residents where they can get exposure to a wide range of skills and work with a very diverse population. This also implies the luxury of time to proceed at a slower pace or at a more in-depth level in working on a case (either therapy or assessment) than the staff psychologists may normally do. This allows the residents to be more confident in making the judgement of when they have met the point of diminishing returns in their work with a client. By the end of the year, however, we would expect the residents to be carrying a more realistic case load in order to be better prepared for the day-to-day experience of working as registered/licensed psychologists.
Psychologists have their offices located throughout the hospital depending on their function. The residents have assigned offices fully equipped with testing and training materials and a computer. They also have direct access to separate play/assessment and family interview rooms equipped with one way mirrors and video equipment.
Supervision
Our program places emphasizes thoughtful supervision, based on the model below:
The residency is based on a mastery model with the following training steps:
1. Observation (Resident of staff).
2. Joint assessment/treatment (Shared responsibility for case management).
3. Observation (staff of Resident) – the observation is direct, requires the staff to be in the room and prepared to intervene if necessary.
4. Resident solo – staff pre- and post-sessions planning and debriefing with the resident (may use audio, video or one way mirror if necessary or appropriate).
5. Arms length supervision – resident carries a case load and goes over each case at regularly scheduled supervision sessions.
It is the individual psychologist’s responsibility to select an appropriate teaching case to work with the resident and to monitor and record the progress directly. It is not expected that the resident would reach the highest levels in the first block of rotation, unless they had prior experience in the area.
The Department of Psychology at BC Children’s Hospital is actively involved in research. Graduate students, post-doctoral fellows and psychologists participate in various projects often in collaboration with medical colleagues in their programmes. Topics addressed in recent or current projects include:
-Effectiveness of a parent training program specifically designed for parents with ADHD -Treatment outcome in children with complex chronic and recurrent pain -Cognitive functioning in children with chronic kidney disease -Risk factors for children referred for investigation of suspected child abuse and neglect -Longitudinal follow-up and case study reports of children with various rare metabolic disorders -Multi-site studies of the safety and treatment effects of sapropterine dihydrochloride for treatment of phenylketonuria -Cognitive and behavioral outcomes of children with congenital heart disease -Infant self-regulation predicts executive functions at preschool age in children born very preterm -Pain and distress recovery as early predictors of temperament in toddlers born preterm -Neonatal pain-related stress in relation to neurodevelopment and behavior in children born preterm -Understanding the psychosocial needs of youth with concurrent mental health and substance use disorders: Informing evidence-based treatment and management
-Effectiveness of a parent training program specifically designed for parents with ADHD
-Treatment outcome in children with complex chronic and recurrent pain
-Cognitive functioning in children with chronic kidney disease
-Risk factors for children referred for investigation of suspected child abuse and neglect
-Longitudinal follow-up and case study reports of children with various rare metabolic disorders
-Multi-site studies of the safety and treatment effects of sapropterine dihydrochloride for treatment of phenylketonuria
-Cognitive and behavioral outcomes of children with congenital heart disease
-Infant self-regulation predicts executive functions at preschool age in children born very preterm
-Pain and distress recovery as early predictors of temperament in toddlers born preterm
-Neonatal pain-related stress in relation to neurodevelopment and behavior in children born preterm
-Understanding the psychosocial needs of youth with concurrent mental health and substance use disorders: Informing evidence-based treatment and management
In keeping with the scientist-practitioner model that serves as the basis for residency training, each resident is expected to present a paper at the end of the residency year, applying some theoretical or research model to the practical setting. Research is defined in its broadest terms and includes everything from creating an annotated bibliography of books that deal with common hospital situations to program evaluation. This might involve, for example, doing a literature search and the work leading up to a formal research proposal on some applied, hospital relevant topic. Alternatively, it could also take the form of an in-depth case study tied to how different therapy approaches would predicate different interventions and different therapeutic outcomes. Designated time is available for this project.
In total, there are approximately 45 psychologists working across the sites that are involved in the training program. All are doctoral-level fully registered members of the College of Psychologists of B.C. or are in the process of obtaining registration in British Columbia and have extensive experience in the health care field gathered over a number of years. Please see the attached staff lists for BC Children's and Sunny Hill for further details.
As would be expected in such a large group, approaches to assessment and therapy are extremely varied so at our site no one specific school of psychology or therapeutic perspective prevails. Consequently, emphasis for the residents is on developing their own therapeutic style and in acquiring a broad base of skills that can be applied in a range of settings. The opportunity to observe and work with psychologists with unique expertise in various health and mental health areas is one of the main assets of the program.